Coasting in the Countertransference

Psychoanalysis in a New Key

by Irwin Hirsch

Winner of the 2009 Goethe Award for Psychoanalytic Scholarship!

Irwin Hirsch, author of Coasting in the Countertransference, asserts that countertransference experience always has the potential to be used productively to benefit patients. However, he also observes that it is not unusual for analysts to 'coast' in their countertransferences, and to not use this experience to help treatment progress toward reaching patients' and analysts' stated analytic goals. He believes that it is quite common that analysts who have some conscious awareness of a problematic aspect of countertransference participation, or of a mutual enactment, nevertheless do nothing to change that participation and to use their awareness to move the therapy forward. Instead, analysts may prefer to maintain what has developed into perhaps a mutually comfortable equilibrium in the treatment, possibly rationalizing that the patient is not yet ready to deal with any potential disruption that a more active use of countertransference might precipitate.

This 'coasting' is emblematic of what Hirsch believes to be an ever present (and rarely addressed) conflict between analysts’ self-interest and pursuit of comfortable equilibrium, and what may be ideal for patients’ achievement of analytic aims. The acknowledgment of the power of analysts’ self-interest further highlights the contemporary view of a truly two-person psychology conception of psychoanalytic praxis. Analysts’ embrace of their selfish pursuit of comfortable equilibrium reflects both an acknowledgment of the analyst as a flawed other, and a potential willingness to abandon elements of self-interest for the greater good of the therapeutic project.

Genres: Psychology, Psychoanalysis

236 pages, Paperback

First published January 1, 2008

Reviews

[Jeremy]

Great book. Really got into the therapists conflict avoidance with our style of relating can lead to conflict avoidance and joining with the patient in an enactment that is keeping the dyad from the more difficult richer material. There is so much life when we play with and are aware of both people in therapy. He said we coast when we take the easy way out, or subtly choosing what works for the therapist over what is best for the patient. The fact that the health of a patient means a loss of financial income for the therapist is at the heart of our conflicts of self interest.

[Boris Tizenberg]

A raw and honest commentary that highlights how aspects of a well meaning therapist and their life may negatively impact or hinder a patient’s progress.

At times, the book feels like a way for the author to alleviate some of the guilt he holds onto from previous patients whom did not make as much progress in therapy as the author hoped. At other times, he appears obviously insecure about himself (e.g. balding), or grappling with the morality of power dynamics and money.

He is very honest in a raw and refreshing way about what made it difficult for him to bring up certain things or stay the course despite resistance. This ultimately humanizes both himself and the experience of therapy, as therapists are often confronted with the challenge of pushing past their own short comings and socialized norms in service of helping the patient.

[Jerry]

This is a short paperback, published last year, which talks about kinds of therapist self-interest which all therapists indulge in - which are rarely mentioned in any literature I've read.
And so it is very refreshing and very thought-provoking.
Despite the fact the author is a relational psychoanalyst, any therapist will find this intriguing and valuable.